Provider Demographics
NPI:1851003479
Name:GLOVER, DANIELLE A (HIS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:GLOVER
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BIRCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-4189
Mailing Address - Country:US
Mailing Address - Phone:931-709-0661
Mailing Address - Fax:931-709-0661
Practice Address - Street 1:2302 CONGRESS PKWY S
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-2820
Practice Address - Country:US
Practice Address - Phone:423-649-3010
Practice Address - Fax:423-649-3010
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1017237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist